|
--SITE.WORK DATE ID/SIG.COMMENTS OWNEll BI]ILDER DET-CARATION . ]Iha.byr,Imu.ddpo.nyofFjuy$rIoddi$nofr0tColrt-r6LtaEr^forrlEfolh$inslt&n(st7o!l.t\t1
<br />Bui.d ad Prcf6br Co<t): Ary Cny or Couny *nah r.qui6 r Fni io ordrud. dlq. iryrct drElirh & E ., ,'
<br />qiu.r6.. Firro,r3 inlldt,.lo nqsiB E +plt.n for sh Fhn lo fil. ! rign d rrdEn lhillo.3lEblkdE d F,ut
<br />b rlE FlvibE of dr Codr-rM r Lko!.d L.w ((t!..ra 9. CoffiinB *irh sdior 7m0 of Dirnion I otlh. BU!6 &d
<br />Pbadbd Cod.) o. d{ lE d {E ir ddtrF tha*.m !i tl' b..ir lor rlE.lLs.d daprioi Any !nhi,. of Sdi.n ?0ll Jhtoy
<br />pli.6r for. FDiI $bjarr rlE +?lid ro . dvil Frhy of tur erc rhd fir. n!.d.d dollE (tt00) a
<br />- -, l. 6 o$e ofrh. FoFry. or oy 6npb,6 wirh *.96 6 dEt $L omFsrion. siu &r llE sat .ld l,E lnarE k ml
<br />iddrLd d otro.d for eL (Sc.7044, aci6 dd EDfshE Codq Ttc Co.n &br't Lr.e Lr* do6 mr {rPly ro d o*E of
<br />thc F6Fry who hrikt or in{rov6 rhdm !d trho AE Mh *orl himclf or h*lf or lhreush hir or lE o*n ffl'ht6.
<br />provid.d rh! rsh ihp.DEEnl n ml intdr,.d m olH ft,r d. lL tFnaG, rh. hilci.g or inp..\sEl it $ld w(hin orc )d
<br />ofo"lpl6iol! tlE O^{q Bdilda will h.E tlE htr&! olFDvilB rhn lE or $. dij rct hiild or imFlrt lh. FsFry aor llE porlor of
<br />l. ! oMd of lhc propaly, m qcluriv.ly coilr..luu $ilh li.o&d .ontado6 ro co.hd rlE .,q..l {Se. 7(x-4. t\!'nd
<br />.d AD&sir codc: Th. Conteioar Licru L.* do6 nor lpplylo u own6 ofFop<ny who build! or imp.o!6lh6on,
<br />&d *to co'rEl! tor iuch Foj.rll wnh. Co,trr..to(.) ltdB.d Fmu,i ro rh.Cotu&roi! Lk.M lrs)
<br />I h trdpl un& S6ri,n W$n86iattalttEdsaf]o! JlECUaArla!
<br />I hd.t, .lfm undd Frnt of Frury om ofilE folb* i,S &<lrabB
<br />I h.E !n wiu ridri. r CdifEn. of C6Mr h S.lf-lM ld qort6 onFBrioo 6 Forid.d lot !y Scrhn 17m of E
<br />t bor Cod.. fr dE Ffqljl.@ of llE Ert li,r *ttn rlE Fhn ir iBu.d.
<br />I n v. .nd Nill mlinl.in porl6 comp.srl ion irourumq 6 r.qunc{t r,y Scr ion .lTm of rh. lrb.t ( od., ntr rhc FforltlM. of
<br />llE $ork lor which thir Fnil i! is€d. My woild coFFronion iBurec cdin ad poli.y nrmh.r r..
<br />I c6rit rhn in rh. Ffollw. of tlE $ort lor Ehi.h thi! Fnn i! isu.d.l3luller anploy o, F$n i. !n, IDiE
<br />o B ro ba.G $t*.l to rlE srtd'odpa6ri,. bs of c.liaomia ,'d.88 thi if I Jbuld bGoE rubjcl ro lE
<br />mrta' omFldio. FririoG of Scrion l7m of rh. t t n Coda I Jdl. fonhunh @mply q nh fior Frir6
<br />WARNINC Fnlw ro :w rvtd onFurbn orGrsc i dlr*tul &d rhrll rub..i e olphF ro sim!,1 Fdis !d
<br />dvil fE up ro oE hrnd.d rbB.rd &lltE (t100.000), in ddnirn lo ft. coc ot.onForio( d.trgd s Foril.d tu llE
<br />Sdirn :1076 of rh. t tor Codc hGd !d .hrElit fc
<br />OECIJAAI]A!
<br />I @y dIm urldd Fulry of Fj!r, rh, I m li€lt d u.<!.r Fl6iotr of CIqFE 9 (o,ffiiry wnh S.dbn 7000) ol Divbion l
<br />ot rhc Bdi6 !n Prcfdiod cod.. dtd ny licog it in tull foN lld cltftr
<br />coNsttucllo LF,u,Nc aGENca
<br />I hdlby .llm utlda !a!ny ot Fjuy rhr rlEr a . onrtudb. ladig .g6y h. $. Ffollrr. olrlE s,t for whkh lllil FDi ir
<br />isr.<t(Sa 109?, Civ. C.).
<br />A?IUI;AtrLDf4:IJBAIIA!
<br />I hrdrytfrn!.d€FrnyoaFjlryoE olrh. follo*inB dc.lr ion!
<br />Dorclirio. PmnlAlb6rd Noific ion Fcddl R.subriotu {Tirl.,ro, Pdr6)
<br />R.qut.d L.rld olNotificlrion
<br />I .d ily rhar ih. f.ddrl r.luhioa Eledns f,itEd rdovrl e. nor mplicabl. ro rhG projdr
<br />I cdily thd I h!v. rdd tht rpplk.rion sd itt. thi rh. !1[v. irfodll Fn is cord I lsrd to conrly * irh .ll ( hy lnd aoot,
<br />ordue6 ad Sl.t. t s! chi,s ro Urildins codrucriotr,n h(cty iurho@. rcFendir6 olrhB Cny.nd counr,ro drd upon dE:x:ffiryw,_tu
<br />P. lic re orLt):
<br />,r/a1rk-
<br />Forms/Steel/Holdowns
<br />Erection Pads
<br />UFER Ground
<br />SLAB Floor
<br />Subf loorA/enVlnsulation
<br />Roof Sheathing
<br />Shear Wall
<br />Framing
<br />ln s u lation/E nerg y
<br />Drywall
<br />Ext./lnt. Lath
<br />Brown Coal
<br />Masonry
<br />Pool Fence
<br />T-Bar
<br />Handicap Req.
<br />Deputy Final Report
<br />Engineer Final Report
<br />Flood Zone Certif
<br />-Filfib-t/rr\?-J.4[vn-\c)
<br />Certificate of Occupancy \7
<br />J.loles, Remarks, Etc.
<br />BUILDING. INSPECTOR RECORD
<br />ran<lq . Add6 _
<br />Set Backs
|